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CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
Prestige Senior Living at Hearthstone operates as a 36-bed skilled nursing facility at 802 East Mountain View Avenue in Ellensburg, Kittitas County, Washington, under the private ownership of David Shepherd. The facility accepts Medicare beneficiaries (accounting for 66% of new admissions), Medicaid residents (7%), and private-pay individuals (27%). Most residents stay 93 days on average, arriving for short-term rehabilitation following hospitalization. The facility currently serves 27 of 36 licensed beds, an occupancy rate of 75% that mirrors the Washington state average of 72.5%.
The rural setting places the community 1.5 miles from downtown Ellensburg and within a quarter-mile of KVH Surgical Services Complex.
Prestige Senior Living’s compliance record presents sustained and serious concerns. The Centers for Medicare & Medicaid Services assigned a 1-star overall rating, with the same 1-star rating in health inspections. Ten inspections since 2024 (the state average is 7.8) documented 40 deficiencies, a 29% excess over the typical Washington nursing home.
The most recent April 2025 inspection identified fire safety documentation gaps, maintenance failures, and blocked emergency exits; part of a documented pattern across multiple inspection cycles. Complaint investigations substantiated resident neglect, incomplete incident investigations, and delayed corrective action submissions. Federal civil penalties have been assessed in four separate instances totaling $231,000 since September 2023; nearly three times the Washington average penalty amount.
Nursing staffing averages 3 hours 6 minutes per resident daily, placing the facility 86th among 89 Washington skilled nursing facilities and 29% below the state average of 4 hours 22 minutes. Industry standards flag nursing levels below 3 hours per day as a significant concern; this facility operates marginally above that threshold.
Clinical quality measures across long-stay residents show performance better than state averages in falls with major injury (0.6% vs. 2.6%), pressure ulcer development (3.5% vs. 4.9%), and antipsychotic medication use (4.9% vs. 14.5%).
The facility’s operational model orients it toward Medicare-eligible short-stay rehabilitation residents; persistent deficiencies in fire safety documentation, resident supervision, and corrective action timeliness characterize the compliance trajectory.
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
This home is ranked 86th out of 89 homes in Washington for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
| Staff type | Hours / Day / Resident | vs state avg |
|---|---|---|
|
Registered Nurse (RN)
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.
| 49m per day | ▼ 10% State avg: 54m per day · National avg: 41m per day |
|
LPN / LVN
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.
| 38m per day | ▼ 20% State avg: 48m per day · National avg: 52m per day |
|
Nurse Aide
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.
| 2h 12m per day | ▼ 18% State avg: 2h 41m per day · National avg: 2h 20m per day |
|
Weekend Total Nursing
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
| 3h 11m per day | ▼ 19% State avg: 3h 57m per day · National avg: 3h 27m per day |
|
Physical Therapist
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
| 9m per day | ▲ 58% State avg: 6m per day · National avg: 4m per day |
|
Weekend RN
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
| 38m per day | ■ Avg State avg: 39m per day · National avg: 29m per day |
Similar to the Washington average: 72.5%Key information about the people who lead and staff this community.
In Washington, the Department of Social and Health Services, Residential Care Services conducts unannounced inspections and issues reports on the quality of care in all licensed settings.
This scorecard compares key inspection, citation, and complaint metrics at this facility against the Washington state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
Deficiencies
| This Facility | WA Average | vs. WA Avg |
|---|---|---|---|
|
Total deficiencies
Formal regulatory issues recorded by inspectors across all inspection types.
| 40 | 31 | This facility has 29% more total deficiencies than a typical Washington nursing home (40 vs. WA avg 31).↑ 29% worse |
|
Deficiencies per year
Average deficiencies per year since 2024.
| 20 | 15.5 | This facility has 29% more deficiencies per year than a typical Washington nursing home (20 vs. WA avg 15.5).↑ 29% worse |
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
Washington average 7.8
Last Health inspection on May 2025
Washington average 48.9
Washington average 6.92
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
48 of 62 citations resulted from standard inspections; and 14 of 62 resulted from complaint investigations.
100% better than Washington averageWashington average: 0.3
253% worse than Washington averageWashington average: 1.7
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
9% more staff per resident than Washington average
0% compared with Washington average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
17 total: 12 full-time employees and 5 contractors.
17
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.3 hoursAssists with medical care and medications.
12 total: 8 full-time employees and 4 contractors.
12
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.6 hoursHelps with daily care and mobility.
75 total: 32 full-time employees and 43 contractors.
75
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.7 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
4,703 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 32 | 43 | 75 | 13,087 | 92 | 100% | 8.7 |
| Registered Nurse | 12 | 5 | 17 | 3,819 | 92 | 100% | 9.3 |
| Licensed Practical Nurse | 8 | 4 | 12 | 3,744 | 92 | 100% | 8.6 |
| Respiratory Therapy Technician | 3 | 0 | 3 | 871 | 72 | 78% | 6.9 |
| Physical Therapy Aide | 1 | 1 | 2 | 517 | 50 | 54% | 7.7 |
| Clinical Nurse Specialist | 1 | 0 | 1 | 516 | 65 | 71% | 7.9 |
| Administrator | 1 | 0 | 1 | 512 | 64 | 70% | 8 |
| Nurse Practitioner | 1 | 0 | 1 | 504 | 63 | 68% | 8 |
| Dental Services Staff | 2 | 0 | 2 | 478 | 60 | 65% | 8 |
| Dietitian | 3 | 0 | 3 | 423 | 59 | 64% | 7 |
| Physical Therapy Assistant | 2 | 0 | 2 | 313 | 39 | 42% | 8 |
| Speech Language Pathologist | 2 | 1 | 3 | 239 | 42 | 46% | 5.4 |
| Other Dietary Services Staff | 1 | 0 | 1 | 171 | 27 | 29% | 6.3 |
| Occupational Therapy Aide | 0 | 1 | 1 | 135 | 23 | 25% | 5.9 |
| Qualified Social Worker | 1 | 0 | 1 | 30 | 10 | 11% | 3 |
| Medical Director | 0 | 1 | 1 | 12 | 12 | 13% | 1 |
Includes penalties issued in 2023-2025
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database (Data as of Jan 2026)
183% higher than Washington averageWashington average: $82K
117% more fines than Washington averageWashington average: 1.8
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0
100% fewer payment denials than Washington averageWashington average: 0.3
Penalties are imposed by CMS for violations of federal nursing home regulations.
4 penalties in the past 3 years
Multiple penalties were reported in the last 3 years.
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Jan 14, 2025
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
May 15, 2024
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Dec 21, 2023
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Sep 22, 2023Last updated: Jan 2026
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
4.9
51% better than Washington averageWashington average: 10.0
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
12.2
42% better than Washington averageWashington average: 20.9
Percent of long-stay residents whose need for help with daily activities has increased
9.5%
42% better than Washington averageWashington average: 16.4%
Percent of long-stay residents whose ability to move independently worsened
9.2%
58% better than Washington averageWashington average: 21.8%
Percent of low risk long-stay residents who lose control of their bowels or bladder
17.8%
27% better than Washington averageWashington average: 24.3%
Percent of long-stay residents experiencing one or more falls with major injury
0.6%
77% better than Washington averageWashington average: 2.6%
Percent of long-stay high risk residents with pressure ulcers
3.5%
29% better than Washington averageWashington average: 4.9%
Percent of long-stay residents with a urinary tract infection
1.8%
In line with Washington averageWashington average: 1.7%
Percent of long-stay residents who lose too much weight
1.8%
69% better than Washington averageWashington average: 5.8%
Percent of long-stay residents who have depressive symptoms
16.1%
In line with Washington averageWashington average: 16.2%
Percent of long-stay residents who received an antipsychotic medication
4.9%
66% better than Washington averageWashington average: 14.5%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
98.8%
In line with Washington averageWashington average: 96.2%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
98.0%
In line with Washington averageWashington average: 93.8%
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
92.2%
5% better than Washington averageWashington average: 88.1%
Percent of short-stay residents who newly received an antipsychotic medication
1.3%
8% better than Washington averageWashington average: 1.4%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
88.3%
8% better than Washington averageWashington average: 82.0%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
66% of new residents, usually for short-term rehab.
27% of new residents, often for short stays.
7% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
62Residents meet regularly to discuss policies, care quality, and activities
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
Historical financial and operational data for Prestige Senior Living at Hearthstone based on CMS SNF Cost Reports.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #80 / 93Payroll — State benchmarkedThis home is ranked 80th out of 93 homes in Washington. Shows total annual staff payroll benchmarked to the Washington average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Pets Allowed
Building Type: Two-story
Transportation Services
Fitness and Recreation
Most residents typically stay for a few weeks or months before returning home or moving on.
1.5 miles from city center
Estimated distance in miles from Ellensburg's city center to Prestige Senior Living at Hearthstone's address, calculated via Google Maps.
— 0.26 miles to nearest hospital (KVH Surgical Services Complex)
Add your location
Prestige Senior Living at Hearthstone is located in Ellensburg, Washington.
Here are the financial assistance programs available to residents in Washington.
The information below is reported by the Washington Department of Social and Health Services, Residential Care Services.
| Prestige Senior Living at Hearthstone |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support. | Ellensburg (East Mountain View Avenue) | 36
Facility
36
WA AVG
82
Rank
#335 / 366 |
75.0%
Facility
75.0%
WA AVG
72.5%
Rank
#152 / 310 | +3% | 3.10
Facility
3.10
WA AVG
4.22
Rank
#86 / 89 | -6% | -27% | $247.1k
Facility
$247.1k
WA AVG
$87.7k
Rank
#85 / 91 | 62
Facility
62
WA AVG
48.9
Rank
#60 / 91 | 6.2
Facility
6.2
WA AVG
6.9
Rank
#43 / 91 | 6 | 27 | - |
42
Facility
42
WA AVG
51
Rank
#398 / 628 | David Shepherd | $12.9M
Facility
$12.9M
WA AVG
$13.2M
Rank
#55 / 93 | $3.9M
Facility
$3.9M
WA AVG
$5.7M
Rank
#80 / 93 | 30.4%
Facility
30.4%
WA AVG
45.5%
Rank
#85 / 93 | 505263 | ||||
| Ellensburg Senior Living |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Ellensburg | 80
Facility
80
WA AVG
82
Rank
#172 / 366 |
85.0%
Facility
85.0%
WA AVG
72.5%
Rank
#74 / 310 | +17% | 3.10
Facility
3.10
WA AVG
4.22
Rank
#86 / 89 | -6% | -27% | $247.1k
Facility
$247.1k
WA AVG
$87.7k
Rank
#85 / 91 | 62
Facility
62
WA AVG
48.9
Rank
#60 / 91 | 6.2
Facility
6.2
WA AVG
6.9
Rank
#43 / 91 | 6 | 68 | A+ |
38
Facility
38
WA AVG
51
Rank
#420 / 628 | David Shepherd | $12.9M
Facility
$12.9M
WA AVG
$13.2M
Rank
#55 / 93 | $3.9M
Facility
$3.9M
WA AVG
$5.7M
Rank
#80 / 93 | 30.4%
Facility
30.4%
WA AVG
45.5%
Rank
#85 / 93 | 505263 |
Prestige Senior Living at Hearthstone is in the East Mountain View Avenue neighborhood of Ellensburg.
Prestige Senior Living at Hearthstone has a walk score of 42. Somewhat walkable. A few nearby services may be reachable on foot, but most trips require transportation.
According to WA state health department records, Prestige Senior Living at Hearthstone's license number is 2683.
According to WA state health department records, Prestige Senior Living at Hearthstone's license expires on March 31, 2027.
Prestige Senior Living at Hearthstone's occupancy is 75%.
Prestige Senior Living at Hearthstone has 36 beds.
Yes — there are 6 photos of Prestige Senior Living at Hearthstone in the photo gallery on this page.
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